腹壁吸脂成形术的临床应用进展:历史、演进与未来OA

Lipoabdominoplasty has evolved into the primary surgical modality for correcting abdominal wall soft-tissue ptosis and reshaping trunk contour,advancing from early techniques of simple dermolipectomy to a comprehensive surgical system that integrates liposuction,fascial repair,and anatomically refined flap management.This review systematically traces the procedure's historical evolution—from rudimentary skin and fat excision toward precision-based techniques preserving the superficial fascial system(Scarpa's fascia)and perforating vessels—and delineates contemporary clinical standards governing indications,contraindications,and aesthetic design principles,including low transverse incision placement and umbilicoplasty.Particular emphasis is placed on critical technical advances:flap management innovations(TULUA technique),seroma prophylaxis(progressive tension sutures and drainless approaches),evidence-based venous thromboembolism(VTE)risk stratification and prevention,perioperative optimization through Enhanced Recovery After Surgery(ERAS)protocols,and minimally invasive endoscopic repair of rectus abdominis diastasis(MILA).The review further examines the expanding indications of lipoabdominoplasty in obese patients,massive weight loss(MWL)populations,and male patients.By synthesizing landmark foundational evidence with contemporary data,this review provides an evidence-based framework to assist clinicians in optimizing surgical decision-making and perioperative management,with the ultimate aim of enhancing both the safety profile and aesthetic outcomes of abdominal contouring surgery.